This article is intended to help you understand what you will find in China, and to provide the information necessary for you to be able to decide whether to take out a health insurance policy and how to choose it.

To do so, we are going to cover the following topics (you can click on the index below to skip directly to the section that you are most interested in).

If you are looking for information on health insurance for short stays or for tourism, while this article may be useful to you, I recommend that you check out this other article.

Medical attention in China

In China, despite the existence of a public health care system, it is not at all similar to the one that exists in Europe (and other countries), where free and universal health care exists. The Chinese public health care system is not universal and is free to an even lesser extent.

In China, primary medical attention and public hospitals are run by the government, and benefit from a certain amount of funding. This makes being admitted and visiting a doctor relatively cheap (between 1 and 5 Yuan). Nonetheless, treatments and drugs are paid in full, and are quite expensive (often more expensive that private hospitals in the West).

One of the particularities of Chinese public hospitals is that their financing depends greatly on the sale of drugs, which makes it so that their prices tend to be much higher than in other countries (most of all for drugs produced abroad). This mainly happens because hospitals have a monopoly on the large majority of drugs.

That means that pharmacies in China tend to have a very limited selection of drugs (normally traditional medicine), and the only way to obtain certain drugs is with a doctor’s prescription, which is only valid in the hospital in which it has been obtained.

A clear example of this is their love of prescribing intravenous medicine, taking x-rays, and adding traditional medicine ingredients to prescriptions. In fact, it is a widespread practice that before an operation, you give extra money to a doctor so that they can “take extra care.”

In addition, nurses tend to not care for patients unless you pay them, which makes it very common for you to see the family members of sick people pushing around beds or wheelchairs in the hospital.

In addition to public medical assistance, there are numerous private hospitals and clinics which are both national and international. Despite the fact that numerous centers do not charge for consultations, treatments and drugs tend to have exorbitant prices.

Why do I need health insurance in China?

As I mentioned in the previous section, medical attention in China is not free, and in many cases, can be more expensive than that of private hospitals in the West. Therefore, if you don’t have adequate health insurance, you can go bankrupt if you suffer from a minor illness or an accident. To get an idea, a minor surgery can cost up to multiple tens of thousands of Yuan.

In addition, you have to remember that in China, they are not going to attend to you if you don’t pay the bill upfront (often in cash) or in the case of certain international hospitals, before you demonstrate that you have health insurance that will cover the treatment.

In China, health care is a business. If you have an accident and you don’t have money or health insurance, as soon as they find out, they are going to kick you out of the hospital.

Hospitals in China

In China, it can be said that there are three types of hospitals: public hospitals, private hospitals, and international hospitals.

Public hospitals

Public hospitals (except for rare exceptions) are far from meeting Western standards, are normally packed with people, the attention is poor, the facilities and hygiene in many cases leave a lot wanting, and their privacy is quite rare. In addition, you have to remember that staff will not speak a single word of English (some doctors might be able to say four or five phrases).
The operation of public hospitals is a bit chaotic:

1) You have to go to the main cash register to sign up (you can’t do it in advance).

2) You have to wait in a long line and pay the fee (normally less than 10 Yuan); they will give you a number for the specialist you have requested. Keep in mind that if you arrive at the hospital late, there might not be any more numbers left. If you haven’t previously been at this hospital, they will give you a card and a booklet where the doctor will note your medical history.

3) After you have received your number, you have to go to the section of the hospital of the specialist chosen and give the number to the reception.

4) You need to wait until they call you by number or name and go to the doctor they have assigned you. Be careful, as lots of people are going to try to get ahead of you. In addition, it is common that while you are talking to the doctor, people come in directly to ask things or to try to wait in line directly in the doctor’s office. In some hospitals, it is possible that they might not call you by number and you have to wait in line in front of the office.

5) After seeing the doctor, he/she will prescribe you drugs or will carry out tests, so you will have to go to the cash register once again and pay.

6) Once you have paid, you need to go to the pharmacy or the place to get your tests done and show your receipt.

7) Repeat numbers 3 to 6 as many times as necessary.

Private hospitals

Private hospitals for both traditional and Western medicine operate in a manner similar to public ones. The only differences are that there are not as many people, the staff is much friendlier, the facilities are better, and at times, staff may even speak English. Obviously, all of this has a price.

International hospitals

International hospitals are obviously also private, meet all of the standards you are accustomed to, their staff, in the majority of cases, speaks fluent English, and normally offers excellent attention. However, considering that these hospitals tend to be frequented by expats with good health insurance, their prices can be exorbitant at times.

Types of health insurance in China

When moving to China, many people don’t worry about health insurance, as they think that the university or company welcoming them will provide one. However, you need to be careful about the health insurance they provide, as not all health insurance is equal. Below, I detail the most typical conditions of insurance policies in China.

University health insurance policies: If you are going to work or study at a university, it’s normal for them to provide health insurance. However, university health insurance is far from ideal. This type of insurance only covers treatment at the university hospital. University hospitals are normally incapable of treating the majority of illnesses, and at the most, they are going to treat you if you have a cold or cut yourself. If the illness or intervention cannot be treated at the university hospital, you pay the fee, visit a doctor, they will tell you that they can’t treat you, and will give you proof of this and send you to another hospital. Later, you go to one of the authorized public hospitals and after paying all of the bills, you go back to the university so that they pay you the percentage corresponding to your insurance.Obviously these insurance policies don’t cover international hospitals. This plus the bureaucracy makes them inconvenient, especially if you are sick or hurt (university hospitals are not capable of treating a fracture), and makes this insurance far from adequate.

This type of insurance is normally used by poor Chinese students to stock up on drugs to later give them to their families, as the drugs are free.

Chinese health insurance: While there is a huge variety among Chinese health insurance policies, the majority of them, especially if they are cheap, only cover public hospital costs. While this type of insurance can be adequate for people who want to save money, it is not very recommendable, as the payment of medical costs is not immediate; rather, you pay out of your pocket first and then later file a claim with the insurance company to reimburse you. Obviously, the paperwork and contracts tend to be exclusively in Chinese.

International health insurance: International health insurance tends to be the most convenient for expats, and as expected, is the most expensive. These insuance policies cover you at international hospitals and some private hospitals. In addition, if you live in one of the main cities in China, such as Shanghai, Beijing, or Guangzhou, among others, the majority of these insurance policies give you the option of the insurance company paying directly at international hospitals. That means that you won’t need to go to the cash register every time you go to the hospital, as your doctor’s bills will be sent directly to your insurance provider. Nonetheless, if you live in a second or third-tier city, you will have to pay first and then make a claim for reimbursement.

What is a broker and why you might need one?

People who aren’t very familiar with private health insurance might not know much about the figure of the broker. A broker is an independent professional (or company) specialized in the insurance sector. They are basically an intermediary between the customer and the insurance company that helps people to choose the most suitable insurance policy and to mediate between the insurance company and the policyholder.

Getting the advice of a broker can be very useful, especially for people who aren’t familiar with health insurance or don’t know very much about the specific market (such as the offering of health insurance policies in China). Below, I detail the main advantages of purchasing a health insurance policy through a broker:

“Free” service: A broker doesn’t charge for advising you when choosing your health insurance policy or after you have purchased the policy when helping you with other claims or questions that might come up. In addition, purchasing an insurance policy through a broker does not cost more than doing it directly with the insurance company. Brokers charge a commission paid by the insurance company for each customer that they refer to it, which means that brokers are interested in giving you good service so that you decide to purchase the insurance policy (and renew it) through them.

Brokers don’t work for insurance companies: Good brokers work with a couple dozen insurance companies. Because of this, they won’t try to sell you a particular insurance policy that isn’t suitable for you. Rather, they will try to find the best insurance policy for you. For a broker, what’s important is that you are happy with their service and therefore decide to buy an insurance policy with them (or to use them to renew your insurance policy).

They are an insurance expert: To be a broker, you need a license (that certifies that you are an insurance expert). A good brokeris familiar with the intricate insurance market and will be capable of guiding you through the complicated conditions and clauses imposed by companies.

After-sale service: Good brokers give you complete after-sale service, meaning that if you have any questions regarding your insurance policy, you can ask for their help. The procedures to follow with insurance companies can be complicated at times, and because of this, it’s important to have the help of an expert to avoid unnecessary charges or problems with the insurance company.

Confidentiality: A good broker has strict confidentiality clauses, which means that you can discuss things that you don’t want your insurance company to find out about with them (as the company might increase your premium).

In our experience, for the majority of people, purchasing a health insurance policy in China through a broker is the best option.

The important thing when trusting a broker is to make sure that they are familiar with the specific insurance market. Insurance policies in the United States (or Europe) don’t operate the same way as in China, and the best companies aren’t necessarily the same ones.

The information contained in this table is for information purposes only, and is a simplification of the information obtained on the websites of the insurance providers. Due to the complexity of health insurance policies, we recommend that you thoroughly read the conditions of the policy that you will choose, before purchasing it.

How to evaluate the features of a health insurance policy

For people who are not familiar with international health insurance, reading a policy may be “Chinese” to you, quite literally. Below, I detail the most common vocabulary in health insurance policies so that you can actually understand what you are purchasing.

Annual limit: This value is the maximum amount that the insurance provider will pay per billing period (one year). If you exceed this limit, you will have to start paying out of your own pocket.

Deductible: This is the amount that you have to pay for medical treatment before the insurance provider begins to pay. For example, if your deductible is $1,000 USD, when you go to the doctor, you will pay for all treatment and consultations so long as the bill is less than $1,000 USD. As soon as the treatment costs more than $1,000 USD, the insurance provider will start to pay. That’s to say, you will only pay $1,000 USD and the remainder will be paid by your insurance.

Direct Billing: Direct billing means that the hospital bills are sent directly to the insurance provider without you having to pay them beforehand.

In-patient: These are treatments that require hospitalization, such as an operation.

Out-patient: These are treatments that do not require hospitalization, such as visiting a specialist, dressing wounds, drugs, and rehabilitation, among others.

Cost Share after deductible : This is the percentage of the cost of treatment that you have to pay after paying the deductible. In the table, 0% means that the insurance provider pays for treatment 100% once the deductible has been reached.

Conclusions

In China, health care is not free, and getting good medical treatment can be quite expensive. Because of this, in our opinion, it is more than recommendable to take out a good international health insurance policy. The risks you expose yourself to without insurance or with poor-quality insurance are too high, and can bankrupt you and your family.

There is no ideal insurance policy for everyone, and when you choose one, you will have to assess your specific needs, your budget, and the risks you want to expose yourself to.

Finally, we strongly recommend, taking into consideration the information in this article, that you thoroughly read the conditions and benefits of an insurance policy before purchasing it or ask for the help of an insurance expert.

Do you need help with health insurance for China?

Do you live in China or are you going to move to China and need help choosing the best health insurance policy for you? Fill out the form below to get personalized advice and a free quotation from the broker we recommend at the moment.

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